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  1. Article ; Online: "In conferences, everyone goes 'health data is the future' ": an interview study on challenges in re-using EHR data for research in Clinical Data Warehouses.

    Priou, Sonia / Lame, Guillaume / Jankovic, Marija / Kempf, Emmanuelle

    AMIA ... Annual Symposium proceedings. AMIA Symposium

    2024  Volume 2023, Page(s) 579–588

    Abstract: More and more hospital Clinical Data Warehouses (CDWs) are developed to gain access to EHR data. The rapid growth of investments in CDWs suggest a real potential for innovation in healthcare. However, it is still not confirmed that CDWs will deliver on ... ...

    Abstract More and more hospital Clinical Data Warehouses (CDWs) are developed to gain access to EHR data. The rapid growth of investments in CDWs suggest a real potential for innovation in healthcare. However, it is still not confirmed that CDWs will deliver on their promises as researchers working with CDWs face many challenges. To gain a better understanding of these challenges and how to overcome them, we conducted a series of semi-structured interviews with EHR data experts. In this article, we share some initial results from the ongoing interview study. Two main themes emerged from the analysis of the transcripts of the interviews: the importance of infrastructures in terms of data and how it is generated, and the difficulty to make care, clinical research, and data science work together. Finally, based on the experts' experience, several recommendations were identified when using a CDW.
    MeSH term(s) Humans ; Data Warehousing ; Hospitals ; Health Facilities ; Qualitative Research
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Journal Article
    ISSN 1942-597X
    ISSN (online) 1942-597X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Collaborative and privacy-enhancing workflows on a clinical data warehouse: an example developing natural language processing pipelines to detect medical conditions.

    Petit-Jean, Thomas / Gérardin, Christel / Berthelot, Emmanuelle / Chatellier, Gilles / Frank, Marie / Tannier, Xavier / Kempf, Emmanuelle / Bey, Romain

    Journal of the American Medical Informatics Association : JAMIA

    2024  

    Abstract: Objective: To develop and validate a natural language processing (NLP) pipeline that detects 18 conditions in French clinical notes, including 16 comorbidities of the Charlson index, while exploring a collaborative and privacy-enhancing workflow.: ... ...

    Abstract Objective: To develop and validate a natural language processing (NLP) pipeline that detects 18 conditions in French clinical notes, including 16 comorbidities of the Charlson index, while exploring a collaborative and privacy-enhancing workflow.
    Materials and methods: The detection pipeline relied both on rule-based and machine learning algorithms, respectively, for named entity recognition and entity qualification, respectively. We used a large language model pre-trained on millions of clinical notes along with annotated clinical notes in the context of 3 cohort studies related to oncology, cardiology, and rheumatology. The overall workflow was conceived to foster collaboration between studies while respecting the privacy constraints of the data warehouse. We estimated the added values of the advanced technologies and of the collaborative setting.
    Results: The pipeline reached macro-averaged F1-score positive predictive value, sensitivity, and specificity of 95.7 (95%CI 94.5-96.3), 95.4 (95%CI 94.0-96.3), 96.0 (95%CI 94.0-96.7), and 99.2 (95%CI 99.0-99.4), respectively. F1-scores were superior to those observed using alternative technologies or non-collaborative settings. The models were shared through a secured registry.
    Conclusions: We demonstrated that a community of investigators working on a common clinical data warehouse could efficiently and securely collaborate to develop, validate and use sensitive artificial intelligence models. In particular, we provided an efficient and robust NLP pipeline that detects conditions mentioned in clinical notes.
    Language English
    Publishing date 2024-04-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1205156-1
    ISSN 1527-974X ; 1067-5027
    ISSN (online) 1527-974X
    ISSN 1067-5027
    DOI 10.1093/jamia/ocae069
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4128: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
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  3. Article ; Online: Impact of the Sars-Cov-2 outbreak on the initial clinical presentation of new solid cancer diagnoses: a systematic review and meta-analysis.

    Marty, Simon / Lamé, Guillaume / Guével, Etienne / Priou, Sonia / Chatellier, Gilles / Tournigand, Christophe / Kempf, Emmanuelle

    BMC cancer

    2024  Volume 24, Issue 1, Page(s) 143

    Abstract: Background: The COVID-19 pandemic might have delayed cancer diagnosis and management. The aim of this systematic review was to compare the initial tumor stage of new cancer diagnoses before and after the pandemic.: Methods: We systematically reviewed ...

    Abstract Background: The COVID-19 pandemic might have delayed cancer diagnosis and management. The aim of this systematic review was to compare the initial tumor stage of new cancer diagnoses before and after the pandemic.
    Methods: We systematically reviewed articles that compared the tumor stage of new solid cancer diagnoses before and after the initial pandemic waves. We conducted a random-effects meta-analysis to compare the rate of metastatic tumors and the distribution of stages at diagnosis. Subgroup analyses were performed by primary tumor site and by country.
    Results: From 2,013 studies published between January 2020 and April 2022, we included 58 studies with 109,996 patients. The rate of metastatic tumors was higher after the COVID-19 outbreak than before (pooled OR: 1.29 (95% CI, 1.06-1.57), I
    Conclusions: Despite inter-study heterogeneity, our meta-analysis showed a higher rate of metastatic tumors at diagnosis after the pandemic. The burden of social distancing policies might explain those results, as patients may have delayed seeking care.
    MeSH term(s) Humans ; Female ; SARS-CoV-2 ; COVID-19/epidemiology ; Pandemics ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Disease Outbreaks
    Language English
    Publishing date 2024-01-29
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2041352-X
    ISSN 1471-2407 ; 1471-2407
    ISSN (online) 1471-2407
    ISSN 1471-2407
    DOI 10.1186/s12885-023-11795-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: National early access programs and clinical trials: What opportunities for early access to therapeutic innovations for patients with malignant melanoma?

    Kempf, Emmanuelle / Zalcman, Gérard / Lebbe, Céleste

    Cancer

    2021  Volume 127, Issue 13, Page(s) 2181–2183

    MeSH term(s) Humans ; Melanoma/drug therapy ; Skin Neoplasms/therapy
    Language English
    Publishing date 2021-03-31
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.33495
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    Uh III Zs.146: Show issues Location:
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  5. Article ; Online: Pharmacology of Tyrosine Kinase Inhibitors: Implications for Patients with Kidney Diseases.

    Hulin, Anne / Gelé, Thibaut / Fenioux, Charlotte / Kempf, Emmanuelle / Sahali, Dil / Tournigand, Christophe / Ollero, Mario

    Clinical journal of the American Society of Nephrology : CJASN

    2023  

    Abstract: Tyrosine kinase inhibitors (TKI) have introduced a significant advancement in cancer management. These compounds are administered orally, and their absorption holds a pivotal role in determining their variable efficacy. They exhibit extensive ... ...

    Abstract Tyrosine kinase inhibitors (TKI) have introduced a significant advancement in cancer management. These compounds are administered orally, and their absorption holds a pivotal role in determining their variable efficacy. They exhibit extensive distribution within the body, binding strongly to both plasma and tissue proteins. Often reliant on efflux and influx transporters, TKI undergo primary metabolism by intestinal and hepatic cytochrome P450 enzymes, with nonkidney clearance being predominant. Owing to their limited therapeutic window, many TKI display considerable intraindividual and interindividual variability. This review offers a comprehensive analysis of the clinical pharmacokinetics of TKI, detailing their interactions with drug transporters and metabolic enzymes, while discussing potential clinical implications. The prevalence of kidney conditions, such as AKI and CKD, among patients with cancer is explored in their effect on TKI pharmacokinetics. Finally, the potential nephrotoxicity associated with TKI is also examined.
    Language English
    Publishing date 2023-12-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.0000000000000395
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6584: Show issues Location:
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  6. Article ; Online: Le système réglementaire français à l’heure du développement de l’immunothérapie anti-tumorale.

    Kempf, Emmanuelle / Lebbé, Céleste / Zalcman, Gérard

    Bulletin du cancer

    2021  Volume 108, Issue 4, Page(s) 343–349

    Title translation The French regulatory system facing the development of antitumor immunotherapy: Issues related to patient access to new therapies according to the French society of ImmunoTherapy against Cancer (FITC).
    MeSH term(s) Antibodies, Monoclonal, Humanized/economics ; Antineoplastic Agents, Immunological/economics ; Drug Costs/legislation & jurisprudence ; France ; Health Services Accessibility/legislation & jurisprudence ; Humans ; Immunotherapy/legislation & jurisprudence ; National Health Programs/economics ; National Health Programs/legislation & jurisprudence ; Neoplasms/drug therapy ; Nivolumab/economics ; Reimbursement Mechanisms/legislation & jurisprudence ; Societies, Medical
    Chemical Substances Antibodies, Monoclonal, Humanized ; Antineoplastic Agents, Immunological ; Nivolumab (31YO63LBSN) ; pembrolizumab (DPT0O3T46P)
    Language French
    Publishing date 2021-03-11
    Publishing country France
    Document type Editorial
    ZDB-ID 213270-9
    ISSN 1769-6917 ; 0007-4551
    ISSN (online) 1769-6917
    ISSN 0007-4551
    DOI 10.1016/j.bulcan.2020.12.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uh III Zs.15: Show issues Location:
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  7. Article ; Online: Effect of the COVID-19 pandemic on colorectal cancer care in France.

    Priou, Sonia / Lamé, Guillaume / Chatellier, Gilles / Tournigand, Christophe / Kempf, Emmanuelle

    The lancet. Gastroenterology & hepatology

    2021  Volume 6, Issue 5, Page(s) 342–343

    MeSH term(s) COVID-19 ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/therapy ; England ; France/epidemiology ; Humans ; Pandemics ; SARS-CoV-2
    Language English
    Publishing date 2021-04-03
    Publishing country Netherlands
    Document type Letter ; Comment
    ISSN 2468-1253
    ISSN (online) 2468-1253
    DOI 10.1016/S2468-1253(21)00095-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Hospital end-of-life care aggressiveness in adult solid tumour patients pre and post COVID-19: retrospective multicentre cohort study.

    Cassam Chenai, Tanya / El Mejdani, Mohamed / Cohen, Ariel / Priou, Sonia / Chatellier, Gilles / Flicoteaux, Rémi / Mhalla, Alaa / Tournigand, Christophe / Kempf, Emmanuelle / Lamé, Guillaume

    BMJ supportive & palliative care

    2024  

    Language English
    Publishing date 2024-03-27
    Publishing country England
    Document type Letter
    ISSN 2045-4368
    ISSN (online) 2045-4368
    DOI 10.1136/spcare-2024-004888
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Association between overweight, obesity, and quality of life of patients receiving an anticancer treatment for prostate cancer: a systematic literature review.

    Depotte, Léonard / Caroux, Maryline / Gligorov, Joseph / Canouï-Poitrine, Florence / Belkacemi, Yazid / De La Taille, Alexandre / Tournigand, Christophe / Kempf, Emmanuelle

    Health and quality of life outcomes

    2023  Volume 21, Issue 1, Page(s) 11

    Abstract: Background: Prostate cancer (PCa) and obesity are two ever-increasing public health issues that can independently impair the quality of life (QOL) of affected patients. Our objective was to evaluate the impact of overweight and obesity on the QOL of ... ...

    Abstract Background: Prostate cancer (PCa) and obesity are two ever-increasing public health issues that can independently impair the quality of life (QOL) of affected patients. Our objective was to evaluate the impact of overweight and obesity on the QOL of patients with PCa receiving an anticancer treatment.
    Methods: We performed a systematic review of the literature using PubMed, Embase, Cochrane Library and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search equation targeted studies that included PCa patients who had a body mass index (BMI) greater than 25 kg/m
    Results: Of 759 identified articles, we selected 20 studies published between 2000 and 2019 of 12,529 patients treated for PCa, including 5549 overweight or obese patients. QOL assessment was performed using nine validated scales and two non-validated questionnaires. Of seven studies on radiotherapy, six found obesity to have a negative impact on patients' QOL (especially urinary, sexual, and bowel-related QOL). Thirteen studies assessed the QOL of patients who underwent radical prostatectomy, with a BMI > 25 kg/m
    Conclusion: Based on the published data, the level of evidence for an association between QOL and overweight or obesity in patients treated for PCa is not high. Prospective cohort studies including this type of patient population are warranted to answer this topical public health issue.
    MeSH term(s) Male ; Humans ; Overweight ; Quality of Life ; Prospective Studies ; Obesity/epidemiology ; Prostatic Neoplasms/drug therapy
    Language English
    Publishing date 2023-01-31
    Publishing country England
    Document type Systematic Review ; Journal Article
    ZDB-ID 2098765-1
    ISSN 1477-7525 ; 1477-7525
    ISSN (online) 1477-7525
    ISSN 1477-7525
    DOI 10.1186/s12955-023-02093-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Why Are Data Missing in Clinical Data Warehouses? A Simulation Study of How Data Are Processed (and Can Be Lost).

    Priou, Sonia / Lame, Guillaume / Jankovic, Marija / Chatellier, Gilles / Bey, Romain / Tournigand, Christophe / Daniel, Christel / Kempf, Emmanuelle

    Studies in health technology and informatics

    2023  Volume 302, Page(s) 202–206

    Abstract: In recent years, the development of clinical data warehouses (CDW) has put Electronic Health Records (EHR) data in the spotlight. More and more innovative technologies for healthcare are based on these EHR data. However, quality assessments on EHR data ... ...

    Abstract In recent years, the development of clinical data warehouses (CDW) has put Electronic Health Records (EHR) data in the spotlight. More and more innovative technologies for healthcare are based on these EHR data. However, quality assessments on EHR data are fundamental to gain confidence in the performances of new technologies. The infrastructure developed to access EHR data - CDW - can affect EHR data quality but its impact is difficult to measure. We conducted a simulation on the Assistance Publique - Hôpitaux de Paris (AP-HP) infrastructure to assess how a study on breast cancer care pathways could be affected by the complexity of the data flows between the AP-HP Hospital Information System, the CDW, and the analysis platform. A model of the data flows was developed. We retraced the flows of specific data elements for a simulated cohort of 1,000 patients. We estimated that 756 [743;770] and 423 [367;483] patients had all the data elements necessary to reconstruct the care pathway in the analysis platform in the "best case" scenarios (losses affect the same patients) and in a random distribution scenario (losses affect patients at random), respectively.
    MeSH term(s) Humans ; Data Warehousing ; Electronic Health Records ; Computer Simulation ; Hospital Information Systems ; Delivery of Health Care
    Language English
    Publishing date 2023-05-19
    Publishing country Netherlands
    Document type Journal Article
    ISSN 1879-8365
    ISSN (online) 1879-8365
    DOI 10.3233/SHTI230103
    Database MEDical Literature Analysis and Retrieval System OnLINE

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